Gambling addiction akin to drug and alcohol cravings

Gambling addiction can have a devastating effect not just on patients, but also their families. It can result in people losing their job, and leave families and children homeless.

We know the condition may have a genetic component – and that the children of gambling addicts are at higher risk of gambling addiction themselves – but we still don’t know the exact parts of the brain involved. Our recent research, published in the journal Translational Psychiatry, identifies key brain areas, and opens avenues for targeted treatments that prevent cravings and relapse.

Gambling addiction activates the same brain pathways as drug and alcohol cravings.

Our findings also suggest connections between the parts of the brain that control our impulses may be weakened in people with gambling addiction.’

The study, funded by the UK Medical Research Council, found that two brain areas, called the insula and nucleus accumbens, are highly active when people with gambling addiction experience cravings.

Activity in these areas, which are found deep in the centre of the brain and involved in decision-making, reward and impulse control, has been previously linked to drug and alcohol cravings.

Problem gambling may affect up to 593,000 people in the UK. The condition can be treated by talking therapies, such as cognitive behavioural therapy, or medications that combat cravings.

In the research, which was conducted between Imperial and the National Problem Gambling Clinic, scientists studied 19 patients with gambling addiction, and 19 healthy volunteers.

The most commonly reported problematic forms of gambling among the patients were electronic roulette and sports gambling.

Each volunteer went into a magnetic resonance imaging scanner – which uses a powerful electromagnet to monitor brain activity – and was shown various images. These included pictures of gambling scenes, such as a roulette wheel or a betting shop.

All participants were asked to rate their level of craving when they saw the images.

The team, which included scientists from the University of British Columbia and the University of Cambridge, then assessed which brain areas were activated when the volunteers experienced cravings.

They found that in problem gamblers, the insula and nucleus accumbens were highly active when they were shown an image associated with gambling, and experienced a craving.

Interestingly, the team also found that weaker connections between the nucleus accumbens and an area called the frontal lobe in problem gamblers were associated with greater craving.

Monitoring activity and connections in the insula and nucleus accumbens in gambling addicts may not only help medics assess effectiveness of a treatment, but may also help prevent relapse – a common problem in addiction.

The group are now investigating which treatments may reduce activity in these areas, in an attempt to reduce cravings.

They would also like to compare the brain activity of problem gamblers with people who gamble but do not have an addiction, to investigate why the addiction escalates in some but not others.

 

Dr Henrietta Bowden-Jones

Dr Henrietta Bowden-Jones is director of the National Problem Gambling Clinic, at Central and North West London NHS Foundation Trust.

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